| NPI | 1740981158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 10016) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A183027) |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2025-09-15 |