NPI | 1164679916 |
---|---|
Former Name | ALICIA EILEEN MINTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 179252) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201604025NP-PP) |
Enumeration Date | 2008-08-23 |
Last Update Date | 2022-03-22 |