| NPI | 1295374171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 7141) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 7141) |
| Enumeration Date | 2019-12-25 |
| Last Update Date | 2023-12-01 |