NPI | 1396134284 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: MN 1758746) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 3408) |
Enumeration Date | 2015-01-14 |
Last Update Date | 2025-09-19 |