| NPI | 1912770066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 10982) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 15384-33) |
| Enumeration Date | 2023-10-31 |
| Last Update Date | 2024-06-27 |