| NPI | 1982560249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 13543) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 17617) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704435746APP25) | |
| Enumeration Date | 2025-12-30 |
| Last Update Date | 2025-12-30 |