| NPI | 1881374734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 10676) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 14596) |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2023-10-11 |