| NPI | 1720045735 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R162428-1)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R1624281)  | 
| 163WG0000X Registered Nurse, General Practice (Licence: MN R1624281)  | |
| 163WP2201X Registered Nurse, Ambulatory Care (Licence: MN R1624281)  | |
| Enumeration Date | 2006-04-26 | 
| Last Update Date | 2023-03-29 |