| NPI | 1699724104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R0919599) |
| Additional Taxonomies | 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: MN R0919599) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2025-09-11 |