| NPI | 1609510817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP8911) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R1452181) |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2025-08-28 |