| NPI | 1194244053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN AG08170049) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 5486) |
| 363L00000X Nurse Practitioner (Licence: WI 10661-33) | |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2025-07-09 |