| NPI | 1336494046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R170098-5) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN r170098-5) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2014-03-11 |