| NPI | 1972755478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R079049) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 079049) |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2009-02-11 |