| NPI | 1982278966 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MN 8196) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 8196) | 
| Enumeration Date | 2021-05-14 | 
| Last Update Date | 2024-07-29 |