| NPI | 1902259872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 4721) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1815087) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2020-12-15 |