| NPI | 1518989052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5894) |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other Surgical Technologist (Licence: MN 84131) |
| 363LF0000X Nurse Practitioner Family (Licence: MN 5894) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2021-05-19 |