| NPI | 1639916521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 11850) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN F06241683) |
| Enumeration Date | 2024-07-09 |
| Last Update Date | 2024-09-25 |