| NPI | 1982470647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 11873) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2435631) |
| Enumeration Date | 2023-12-04 |
| Last Update Date | 2024-07-30 |