| NPI | 1396012019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 4708-33) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R210763-9) |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2024-06-17 |