NPI | 1043563463 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP0403) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: MN R184825-8) |
363LF0000X Nurse Practitioner, Family (Licence: MN F1012160) | |
Enumeration Date | 2012-10-23 |
Last Update Date | 2015-03-03 |