| NPI | 1396749222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MN R 075047-3) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist Adult Health (Licence: MN R 075047-3) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2008-09-24 |