| NPI | 1730115841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R95133-7) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 095133-7) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2012-10-01 |