NPI | 1215436076 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 1977213) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 5725) |
Enumeration Date | 2018-02-07 |
Last Update Date | 2019-02-11 |