| NPI | 1104661818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 11803) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2358271) |
| Enumeration Date | 2024-06-26 |
| Last Update Date | 2024-07-23 |