| NPI | 1669049706 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MN 10670) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 223905) | 
| 363L00000X Nurse Practitioner (Licence: MN 10670) | |
| 363L00000X Nurse Practitioner (Licence: WI 11405) | |
| Enumeration Date | 2021-06-08 | 
| Last Update Date | 2023-10-13 |