| NPI | 1497421366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 10119) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ RN197322) |
| 363L00000X Nurse Practitioner (Licence: WI 13676) | |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2023-04-26 |