NPI | 1124218102 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 722) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 137363-9) |
Enumeration Date | 2007-07-26 |
Last Update Date | 2020-03-26 |