| NPI | 1700437183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 10564) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019030538) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 79169) | |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2024-05-06 |