| NPI | 1639534985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP 4422) |
| Additional Taxonomies | 163WR0400X Registered Nurse, Rehabilitation (Licence: MN 190939-1) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2021-03-11 |