| NPI | 1043694672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3992) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 9041) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2021-12-21 |