| NPI | 1750961710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8345) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A162972) |
| Enumeration Date | 2021-04-13 |
| Last Update Date | 2021-08-11 |