| NPI | 1841814753 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 9558) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 27429) | 
| Enumeration Date | 2020-06-05 | 
| Last Update Date | 2024-11-22 |