| NPI | 1255731220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R1865943) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 2563) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2024-08-05 |