| NPI | 1881944858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4984) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 5037-33) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 5037-33) | |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2024-12-18 |