| NPI | 1649073610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 12689) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 16684) |
| Enumeration Date | 2025-03-27 |
| Last Update Date | 2025-06-03 |