| NPI | 1912130238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK 170696) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AK 170696) |
| 163W00000X Registered Nurse (Licence: MN R 182360-0) | |
| 163W00000X Registered Nurse (Licence: WI 155165-030) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 2009007900) | |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2024-03-25 |