| NPI | 1376516005 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 81) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R102325-1) | 
| Enumeration Date | 2006-02-13 | 
| Last Update Date | 2024-10-27 |