| NPI | 1477530053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1098) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 1098) |
| 363L00000X Nurse Practitioner (Licence: MN R103517-1) | |
| 163W00000X Registered Nurse (Licence: MN R103517-1) | |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2021-02-08 |