| NPI | 1558745661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP4011) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP4011) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 4011) | |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2022-08-15 |