| NPI | 1790525582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MN 11307) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MN 11307) |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2025-08-18 |