| NPI | 1699982876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R 0936556) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R-093655-6) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2018-02-14 |