| NPI | 1306611777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND 200089) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: MN 2012931) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: MN 11013) | |
| 363LF0000X Nurse Practitioner Family (Licence: MN 11013) | |
| Enumeration Date | 2023-11-16 |
| Last Update Date | 2024-07-08 |