| NPI | 1184693921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R0863629) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R0863629) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2010-06-09 |