| NPI | 1912382490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8242) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: MN R 210932-3) |
| 163WH0200X Registered Nurse, Home Health (Licence: MN R 210932-3) | |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2023-07-12 |