| NPI | 1124569041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4971) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 1745474) |
| 163W00000X Registered Nurse (Licence: WI 241302) | |
| 363L00000X Nurse Practitioner (Licence: WI 10568) | |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2024-01-30 |