NPI | 1538045075 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN F06251854) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2479831) |
163W00000X Registered Nurse (Licence: WI 1116840-30) | |
Enumeration Date | 2025-08-12 |
Last Update Date | 2025-08-18 |