| NPI | 1073590881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP 3385) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R1311329) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2016-10-04 |