NPI | 1255782132 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R35320) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R-207171-0) |
Enumeration Date | 2016-06-22 |
Last Update Date | 2018-11-01 |