| NPI | 1962019596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 11978) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 7912371-4405) |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2025-01-17 |