| NPI | 1790921732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MN L045270-0) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MN L045270-0) |
| Enumeration Date | 2008-12-22 |
| Last Update Date | 2008-12-22 |