| NPI | 1154954717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 7051) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 1857045) |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2022-09-01 |