NPI | 1306271614 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R223315-0) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN CNS3222) |
363LF0000X Nurse Practitioner, Family (Licence: CA 23367) | |
Enumeration Date | 2013-09-05 |
Last Update Date | 2023-12-01 |