| NPI | 1982029567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 327) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 126193-2) |
| Enumeration Date | 2014-02-19 |
| Last Update Date | 2020-10-06 |