| NPI | 1982184354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 6164) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN NA) |
| 207Q00000X Family Medicine (Licence: MN 6164) | |
| 207Q00000X Family Medicine (Licence: MN 1963845) | |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2022-08-03 |