NPI | 1578693420 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R 115897-7) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 0868) |
Enumeration Date | 2007-03-07 |
Last Update Date | 2024-04-02 |