| NPI | 1518199231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 573) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R133099-9) |
| 363L00000X Nurse Practitioner (Licence: WI 9977) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11031124) | |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2024-05-28 |