| NPI | 1336802685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8629) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 306563) |
| Enumeration Date | 2021-10-14 |
| Last Update Date | 2024-11-07 |