| NPI | 1073382065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 11071) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 235403) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 15763-33) | |
| Enumeration Date | 2024-01-01 |
| Last Update Date | 2024-09-04 |