| NPI | 1154063485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 9145) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 2439666) |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2022-05-03 |