| NPI | 1841296555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD R022487) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R-158898-7) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2007-07-08 |