| NPI | 1912666579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 22188) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 8834) |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2022-04-22 |