| NPI | 1053163378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MN R131580-4) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MN R131580-4) |
| Enumeration Date | 2024-04-02 |
| Last Update Date | 2025-04-23 |