NPI | 1144578568 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP0497) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R178810-1) |
Enumeration Date | 2012-08-15 |
Last Update Date | 2018-09-26 |