| NPI | 1912357716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4528) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R177120) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2021-03-05 |