| NPI | 1902625874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 11647) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2475201) |
| Enumeration Date | 2024-10-08 |
| Last Update Date | 2024-11-24 |