| NPI | 1952065286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 8960) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11016106) |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2023-01-06 |