| NPI | 1174151898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 11994) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 11994) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 11994) | |
| 163W00000X Registered Nurse (Licence: MN 2469429) | |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2026-01-12 |