| NPI | 1962721472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1390) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 157772-3) |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2020-08-10 |