| NPI | 1972261972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MN 8839) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: MN 2151203) |
| Enumeration Date | 2021-12-07 |
| Last Update Date | 2021-12-07 |