NPI | 1083811780 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 162) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 136112-0) |
363LF0000X Nurse Practitioner, Family (Licence: MN 162) | |
Enumeration Date | 2007-06-27 |
Last Update Date | 2020-08-07 |