NPI | 1083602395 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MN R084250-1) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 084250-1) |
Enumeration Date | 2005-10-11 |
Last Update Date | 2009-01-12 |