| NPI | 1033542956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 6576) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 186165-9) |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2021-01-29 |