| NPI | 1124622444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 7480) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 297263) |
| Enumeration Date | 2020-11-27 |
| Last Update Date | 2026-03-24 |