| NPI | 1295298610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 6381) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MN F10181362) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2021-03-16 |