| NPI | 1003459629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 7967) |
| Additional Taxonomies | 163WM0102X Registered Nurse, Maternal Newborn (Licence: MN 201394-3) |
| 363L00000X Nurse Practitioner (Licence: WI 10110) | |
| Enumeration Date | 2019-10-27 |
| Last Update Date | 2023-05-25 |