| NPI | 1205890316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO APN.0998384-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 23313) |
| 363L00000X Nurse Practitioner (Licence: MN R1556650) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2023-03-07 |