| NPI | 1770973760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 21795) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 3764) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2022-09-12 |