| NPI | 1093869711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2564) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 2006007942) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 2564) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2024-02-23 |