| NPI | 1063797413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 204416-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 204416-1) |
| 163W00000X Registered Nurse (Licence: MO 2009027212) | |
| 163W00000X Registered Nurse (Licence: KS 13-101356-062) | |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2021-01-07 |