| NPI | 1659989200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MN 7562) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MN 7562) |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2022-03-31 |