| NPI | 1982783510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND R21255) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1003365) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2007-07-08 |