| NPI | 1164761979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP2308) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R-179056-8) |
| Enumeration Date | 2013-02-14 |
| Last Update Date | 2019-03-29 |