| NPI | 1992980429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 411) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 157121-1) |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2023-01-17 |