NPI | 1104278035 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9533) |
Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: MN 225863-0) |
Enumeration Date | 2016-07-03 |
Last Update Date | 2020-10-06 |