NPI | 1629363429 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 6292) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000888) |
363LF0000X Nurse Practitioner, Family (Licence: IA A-109497) | |
363LF0000X Nurse Practitioner, Family (Licence: WI 7871-33) | |
Enumeration Date | 2011-06-09 |
Last Update Date | 2024-01-15 |