| NPI | 1174945513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN AG0314008) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 196114-8) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MN AG0314008) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MN AG0314008) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN AG0314008) | |
| Enumeration Date | 2014-01-18 |
| Last Update Date | 2014-03-17 |