| NPI | 1902263866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4189) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 200885-1) |
| Enumeration Date | 2016-01-24 |
| Last Update Date | 2023-04-13 |