| NPI | 1558372953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R0713753) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MN 1305) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2008-05-20 |