| NPI | 1902258502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 4700) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 2366124) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: ND R37224) | |
| 363L00000X Nurse Practitioner (Licence: ND R37224) | |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2020-04-16 |