| NPI | 1992855043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP2023) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R153671-9) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-09-17 |