| NPI | 1982133476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP5306) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R1255045) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-03-16 |