| NPI | 1235809070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 8552) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2457406) |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2021-12-01 |