| NPI | 1134854391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 9355) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ND R39739) |
| Enumeration Date | 2022-07-21 |
| Last Update Date | 2022-10-13 |