| NPI | 1003573445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8752) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 8752) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 8752) | |
| Enumeration Date | 2021-11-19 |
| Last Update Date | 2024-04-01 |