| NPI | 1700421211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 5198) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 2016027219) |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2022-05-05 |