| NPI | 1275286551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 9515) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A165927) |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2023-02-28 |