| NPI | 1154629491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R 200778-4) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 2927) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2020-08-07 |