| NPI | 1144074550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 11916) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 28023) |
| Enumeration Date | 2024-04-12 |
| Last Update Date | 2025-06-05 |