| NPI | 1992101620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3453) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R142588-8) |
| Enumeration Date | 2014-11-06 |
| Last Update Date | 2022-11-07 |