| NPI | 1811188022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3651) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 6216) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2021-04-27 |