| NPI | 1407946866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R-0950435) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MN R-0950435) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2009-02-27 |