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 |