| NPI | 1558148387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 10647) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 10647) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 10647) | |
| Enumeration Date | 2023-09-14 |
| Last Update Date | 2023-09-14 |