| NPI | 1073810404 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 12324) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 790561) | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 16304-33) | |
| Enumeration Date | 2011-02-21 | 
| Last Update Date | 2025-01-23 |