| NPI | 1518597954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 10853) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 8963) |
| 163W00000X Registered Nurse (Licence: MN 2143237) | |
| Enumeration Date | 2020-01-24 |
| Last Update Date | 2024-04-17 |