| NPI | 1124634373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 9695) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL TPAN1592) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: KS 53-79722-082) | |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2024-03-01 |