| NPI | 1659533313 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8057) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 099439-4) | 
| 363L00000X Nurse Practitioner (Licence: WI 68897) | |
| 363L00000X Nurse Practitioner (Licence: MN 93) | |
| Enumeration Date | 2008-06-25 | 
| Last Update Date | 2024-01-22 |