| NPI | 1871823773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 5594) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 5594) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 5375064032) | |
| Enumeration Date | 2009-12-28 |
| Last Update Date | 2020-11-10 |