| NPI | 1265976732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN F1216164) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 207952-1) |
| Enumeration Date | 2016-12-18 |
| Last Update Date | 2023-02-17 |