| NPI | 1083455737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 11705) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2367453) |
| 363LF0000X Nurse Practitioner Family (Licence: MN 11705) | |
| Enumeration Date | 2024-06-05 |
| Last Update Date | 2024-09-18 |