| NPI | 1629176763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP0778) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN RNRO764812) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MN ANCC20233321) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2015-09-27 |