| NPI | 1710396809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R166514-0) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP1490) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2025-02-26 |