| NPI | 1063665974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 9203) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R184632-8) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 9203) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 9203) | |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2024-03-28 |