| NPI | 1265320493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 13045) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 1733233) |
| 163W00000X Registered Nurse (Licence: MN 2475674) | |
| Enumeration Date | 2025-06-26 |
| Last Update Date | 2025-08-31 |