| NPI | 1912366543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 12150) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201600950NP-PP) |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2025-07-23 |