| NPI | 1295660488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN AG06260089) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2474087) |
| Enumeration Date | 2026-06-17 |
| Last Update Date | 2026-07-14 |