| NPI | 1295040251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R 170742-5) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: WI 152205-30) |
| 163WN0002X Registered Nurse Neonatal Intensive Care (Licence: WI 152205-30) | |
| 363LF0000X Nurse Practitioner Family (Licence: WI 4167-33) | |
| 163W00000X Registered Nurse (Licence: MN R 170742-5) | |
| Enumeration Date | 2010-08-15 |
| Last Update Date | 2011-01-31 |