NPI | 1063836294 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5882) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA 12209) |
Enumeration Date | 2014-02-07 |
Last Update Date | 2020-10-05 |