| NPI | 1417830928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND 202865) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 12505) |
| Enumeration Date | 2025-07-30 |
| Last Update Date | 2025-12-11 |