| NPI | 1780193110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 13773) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 10561) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2026-02-07 |