| NPI | 1083677769 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R 148960-4)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A087738)  | 
| Enumeration Date | 2006-04-11 | 
| Last Update Date | 2017-05-03 |