| NPI | 1710592530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MN 2149914) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 8864) |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2022-06-16 |