| NPI | 1689338162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8975) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN F09210609) |
| Enumeration Date | 2021-10-29 |
| Last Update Date | 2022-07-01 |