| NPI | 1740578475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 6486) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 4441) |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2025-11-25 |