| NPI | 1205648631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 13013) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MN 13013) |
| Enumeration Date | 2025-01-22 |
| Last Update Date | 2026-03-06 |