NPI | 1568965200 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP6412) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R2469878) |
363L00000X Nurse Practitioner (Licence: TN 192990) | |
363LF0000X Nurse Practitioner, Family (Licence: MN 6412) | |
Enumeration Date | 2018-03-08 |
Last Update Date | 2019-08-05 |