| NPI | 1669022026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 6904) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 102184-875) |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2024-10-01 |