| NPI | 1265001242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8233) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 15818-33) |
| 163W00000X Registered Nurse (Licence: MN 1961407) | |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2025-11-20 |