| NPI | 1023568763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP4806) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MN CNP4806) |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2023-07-20 |