| NPI | 1588494454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 15466) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 11923) |
| Enumeration Date | 2024-08-06 |
| Last Update Date | 2024-10-23 |