| NPI | 1538045075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN F06251854) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2479831) |
| 163W00000X Registered Nurse (Licence: WI 1116840-30) | |
| Enumeration Date | 2025-08-12 |
| Last Update Date | 2025-08-18 |