| NPI | 1821235128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4634) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R-179436-4) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 4634) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MN CNP 4634) | |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2024-09-09 |