| NPI | 1992009583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 7282) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 240878-30) |
| 163W00000X Registered Nurse (Licence: MN R 174364-1) | |
| Enumeration Date | 2010-12-22 |
| Last Update Date | 2021-09-21 |