| NPI | 1982992350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 828) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN r-156344-9) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2019-10-09 |