| NPI | 1023756301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN F12250549) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2025-12-29 |