| NPI | 1275101362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 7598) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN F06201490) |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2021-08-18 |