| NPI | 1225662174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1556605) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 7625) |
| Enumeration Date | 2020-03-01 |
| Last Update Date | 2024-10-22 |