| NPI | 1023398971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5094) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 1682773) |
| 363L00000X Nurse Practitioner (Licence: MN 6104) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A106975) | |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2020-09-15 |