| NPI | 1609632009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 11571) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2459812) |
| Enumeration Date | 2024-02-23 |
| Last Update Date | 2024-05-06 |