| NPI | 1912510694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 7525) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 10889) |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2024-08-05 |