| NPI | 1710439260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4823) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP4823) |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2020-08-07 |