NPI | 1629454509 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4018) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP4018) |
Enumeration Date | 2015-08-03 |
Last Update Date | 2020-08-07 |