| NPI | 1023191343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5011239) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R 156736-4) |
| 363L00000X Nurse Practitioner (Licence: NC 5011239) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2024-08-16 |