| NPI | 1508020769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R164842-9) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 2008004429) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN R164842-9) | |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2023-03-29 |