| NPI | 1215981758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IA H160768) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1976492) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 4043) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2023-05-17 |