| NPI | 1366427049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP 1412) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R084426-6) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2016-09-15 |