| NPI | 1871862219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 2703) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 2703) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R-137121-7) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 4716-33) | |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2023-03-16 |