| NPI | 1003508318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 10763) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2015080) |
| Enumeration Date | 2023-05-24 |
| Last Update Date | 2023-09-22 |