| NPI | 1629632443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 6545) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD 021993) |
| 163W00000X Registered Nurse (Licence: MN 1359873) | |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2019-04-30 |