NPI | 1134266042 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4602) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4602) |
Enumeration Date | 2007-01-31 |
Last Update Date | 2020-08-07 |