| NPI | 1659836070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 6426) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN AG02190059) |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2021-03-11 |