| NPI | 1093147142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2013006750) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN r179726-0) |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2013-08-08 |