| NPI | 1750706784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN AG0314015) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 185992-0) |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2014-06-11 |