| NPI | 1982454336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 12227) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2155157) |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2025-02-10 |