| NPI | 1467059048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 7836) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ND R41822) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2022-07-06 |