| NPI | 1417570391 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8397)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2206543)  | 
| Enumeration Date | 2020-05-26 | 
| Last Update Date | 2024-12-16 |