NPI | 1285612853 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2584) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R-124159-6) |
363LF0000X Nurse Practitioner, Family (Licence: MN 2584) | |
Enumeration Date | 2006-01-04 |
Last Update Date | 2020-08-07 |