| NPI | 1386080588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP2908) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R1356290) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP 2908) | |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2019-08-07 |