| NPI | 1710218151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 5091) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 8039444) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 80289 -030) | |
| Enumeration Date | 2010-01-25 |
| Last Update Date | 2018-06-21 |