| NPI | 1972577153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1406) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R093071-4) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2019-04-16 |