| NPI | 1922845759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 12833) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 354779) |
| Enumeration Date | 2024-07-10 |
| Last Update Date | 2025-07-08 |