NPI | 1376081133 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4989) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R192981-8) |
Enumeration Date | 2017-02-01 |
Last Update Date | 2024-01-05 |