NPI | 1114951688 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R 102120-8) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 102120-8) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2012-07-03 |