| NPI | 1396472106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 11079) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017191) |
| Enumeration Date | 2022-08-02 |
| Last Update Date | 2024-05-20 |