| NPI | 1295157634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 6711) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016036656) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76188-122) | |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: MO 2013034497) | |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: KS 53-76188-122) | |
| Enumeration Date | 2014-01-18 |
| Last Update Date | 2025-01-07 |