| NPI | 1841480548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R 194212-5) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 148807) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ AP5054) | |
| Enumeration Date | 2007-07-28 |
| Last Update Date | 2013-06-26 |