| NPI | 1346921780 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 10826) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 1426434) | 
| Enumeration Date | 2023-07-27 | 
| Last Update Date | 2024-01-20 |