| NPI | 1407201502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health (Licence: MN 1343) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MN 513235) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2019-07-19 |