| NPI | 1629341250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AR 214093) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AR 214093) |
| 163W00000X Registered Nurse (Licence: MN R173860-1) | |
| 363L00000X Nurse Practitioner (Licence: MN 217) | |
| 363A00000X Physician Assistant (Licence: MN 1738601) | |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2024-03-04 |