| NPI | 1558370247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MN R 116602-4) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 0381583-21) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2007-07-08 |