| NPI | 1700320967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 4601) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN APRN CNP 4601) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 2023522) | |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2020-09-17 |