NPI | 1548872963 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 11338) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201902527RN) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 2377252) | |
Enumeration Date | 2020-08-18 |
Last Update Date | 2024-09-10 |