| NPI | 1730616756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP5105) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 5105) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2025-04-02 |