| NPI | 1477396125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 11959) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2462044) |
| Enumeration Date | 2024-06-18 |
| Last Update Date | 2024-09-23 |