| NPI | 1114620689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 9941) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5022717) |
| Enumeration Date | 2023-03-23 |
| Last Update Date | 2025-12-30 |