| NPI | 1710232699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 7900) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R 179752-9) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2020-05-12 |