| NPI | 1710265368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 3614) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 3614) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2024-09-03 |