| NPI | 1376607069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R176991-3) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 137840) |
| 163W00000X Registered Nurse (Licence: MI 4704180891) | |
| 363L00000X Nurse Practitioner (Licence: MO 151802) | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2023-03-07 |