| NPI | 1013559491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 6751) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ND R39551) |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2022-04-04 |