| NPI | 1871295063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 9384) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN AG02220125) |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2023-09-05 |