| NPI | 1851679047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 124) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R2089579) |
| 363L00000X Nurse Practitioner (Licence: WA AP60222903) | |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2021-03-24 |