| NPI | 1669759429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4754-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 147227-1) |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2021-09-16 |