| NPI | 1790631844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 13058) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MN 13058) |
| Enumeration Date | 2026-03-09 |
| Last Update Date | 2026-03-09 |