| NPI | 1184172066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 4804) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2313481) |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2026-05-05 |