| NPI | 1851836464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5032) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN CNP 5032) |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2020-11-10 |