| NPI | 1821437955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP4827) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN623404) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2022-08-12 |