NPI | 1619225653 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2967) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R164708-0) |
Enumeration Date | 2012-08-23 |
Last Update Date | 2020-08-10 |