| NPI | 1003229204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R2204752) |
| Additional Taxonomies | 163WE0900X Registered Nurse Enterostomal Therapy (Licence: IA 108831) |
| 363LF0000X Nurse Practitioner Family (Licence: IA A108831) | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-12-22 |