| NPI | 1972824290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN F0610235) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 179417-9) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2018-03-30 |