| NPI | 1649638339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4384) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MN CNP 4384) |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2021-05-13 |