| NPI | 1104667427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 9655) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 9655) |
| Enumeration Date | 2024-06-03 |
| Last Update Date | 2024-06-03 |