| NPI | 1770037574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN CNP4734) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: ND R38221) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MN R216268-7) | |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2021-07-02 |