NPI | 1366892689 |
---|---|
Former Name | LAURIE HANSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R2446727) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001095) |
Enumeration Date | 2016-06-17 |
Last Update Date | 2018-03-17 |