| NPI | 1629851894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 10611) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: MN 2458734) |
| 363L00000X Nurse Practitioner (Licence: MN 10611) | |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2023-11-15 |