| NPI | 1821075649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP 0870) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 0984443) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2020-11-10 |