| NPI | 1104250257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MN R156559-9) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MN CNP2292) |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2016-05-04 |