| NPI | 1124752415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 9578) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2323468) |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2024-11-04 |