| NPI | 1821597733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 7239) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 8251-33) |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2020-03-17 |