NPI | 1154676229 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2048507) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 1144) |
Enumeration Date | 2012-07-16 |
Last Update Date | 2024-05-09 |