| NPI | 1538547799 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2369) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 2369) | 
| Enumeration Date | 2015-05-08 | 
| Last Update Date | 2025-01-22 |