| NPI | 1194348177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8419) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 1847369) |
| Enumeration Date | 2020-05-25 |
| Last Update Date | 2024-02-06 |