| NPI | 1306215744 |
|---|---|
| Other Name | N/A N/A N/A |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP4107) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP4107) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN CNP4107) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MN CNP4107) | |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2022-07-21 |