| NPI | 1932487469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 0092) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R193569-5) |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2020-08-10 |