| NPI | 1710308234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1787) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R 192337-7) |
| Enumeration Date | 2013-12-31 |
| Last Update Date | 2025-01-09 |