| NPI | 1952480311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3723) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO 102276) |
| 363L00000X Nurse Practitioner (Licence: MN 2254977) | |
| Enumeration Date | 2006-11-04 |
| Last Update Date | 2020-08-07 |