| NPI | 1962716241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1227) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R168765-5) |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2020-10-05 |