| NPI | 1982293726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 10662) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A158411) |
| 363L00000X Nurse Practitioner (Licence: MN 7308) | |
| Enumeration Date | 2021-01-15 |
| Last Update Date | 2024-02-09 |