NPI | 1366827552 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4037) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 6516 - 33) |
Enumeration Date | 2015-07-29 |
Last Update Date | 2018-03-17 |