NPI | 1467059048 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MN 7836) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: ND R41822) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-10-06 |
Last Update Date | 2022-07-06 |