| NPI | 1659653301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 76607) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R131016-8) |
| Enumeration Date | 2011-09-19 |
| Last Update Date | 2026-02-04 |