| NPI | 1124793369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MN 8563) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2457445) |
| Enumeration Date | 2021-08-10 |
| Last Update Date | 2021-10-01 |