| NPI | 1174287478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 9820) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 107430) |
| Enumeration Date | 2021-10-24 |
| Last Update Date | 2025-08-11 |