| NPI | 1912288762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 4702) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 202052-5) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 202052-5) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 4702) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 151209) | |
| Enumeration Date | 2011-09-07 |
| Last Update Date | 2016-07-13 |