| NPI | 1154886992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 6477) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 2018073573) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 1333718) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 6477) | |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2023-05-09 |