NPI | 1104388644 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 6514) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 6514) |
Enumeration Date | 2019-04-03 |
Last Update Date | 2023-05-10 |