| NPI | 1790579878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 12895) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN RN2081946-2626417) |
| Enumeration Date | 2025-04-05 |
| Last Update Date | 2025-06-11 |