| NPI | 1558370247 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MN R 116602-4) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 0381583-21) | 
| Enumeration Date | 2006-08-05 | 
| Last Update Date | 2025-09-11 |