| NPI | 1336911551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 12365) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ND R39081) |
| Enumeration Date | 2023-10-23 |
| Last Update Date | 2026-03-09 |