| NPI | 1790769990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 12169) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 2743) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 024002622) | |
| 367A00000X Advanced Practice Midwife (Licence: MN R0974974) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2022-11-10 |