| NPI | 1124744628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 9718) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2491697) |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2022-12-01 |