| NPI | 1861164261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R1657915) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 193288-30) |
| Enumeration Date | 2021-10-04 |
| Last Update Date | 2022-06-14 |