| NPI | 1306630868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 13163) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2479720) |
| Enumeration Date | 2025-04-08 |
| Last Update Date | 2025-09-10 |