| NPI | 1033564331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2520909) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 16715-33) |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2025-07-02 |