| NPI | 1528099553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R 104826-5) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 0221364-21) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 95231) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2011-12-12 |