| NPI | 1942289863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1404) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1438985) |
| 363L00000X Nurse Practitioner (Licence: MN R-143898-5) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2020-09-28 |