| NPI | 1740217553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2747) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R0726591) |
| 363LF0000X Nurse Practitioner, Family (Licence: MT RN19057) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2024-01-23 |