| NPI | 1023685138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8275) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 8275) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 8275) | |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2022-08-22 |