| NPI | 1043563463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN CNP0403) |
| Additional Taxonomies | 163WM0705X Registered Nurse Medical-Surgical (Licence: MN R184825-8) |
| 363LF0000X Nurse Practitioner Family (Licence: MN F1012160) | |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2015-03-03 |