| NPI | 1013784883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 14838) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 11212) |
| Enumeration Date | 2023-12-11 |
| Last Update Date | 2024-01-25 |