| NPI | 1609276542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2655) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 195667-4) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 2655) | |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2023-05-09 |