| NPI | 1306712740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 13672) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1108092) |
| Enumeration Date | 2025-10-14 |
| Last Update Date | 2026-01-14 |