NPI | 1013471242 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP6527) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R241530-5) |
Enumeration Date | 2019-01-22 |
Last Update Date | 2024-05-30 |