| NPI | 1285829754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 864) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R153888-5) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R 153888-5) | |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2023-01-13 |