NPI | 1184075525 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 4864) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 1617979-1) |
Enumeration Date | 2016-06-27 |
Last Update Date | 2019-03-02 |