| NPI | 1174754543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2006) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209007701) |
| 363L00000X Nurse Practitioner (Licence: MN R 156503-6) | |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2020-08-07 |