| NPI | 1356750822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 1840) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: MN 1840) |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2019-02-13 |