| NPI | 1477939338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 12078-033) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP 4055) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4055) | |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2026-04-24 |