| NPI | 1114476512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 4838) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R1935776) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2022-01-20 |