NPI | 1346626579 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP4093) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 116139-1) |
Enumeration Date | 2015-08-11 |
Last Update Date | 2020-08-10 |