| NPI | 1477840379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R 158239-4) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 328016) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 10941) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2014-01-15 |