NPI | 1639139892 |
---|---|
Former Name | TAMARA S BREVIK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2325) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN R130953-5) |
Enumeration Date | 2006-03-23 |
Last Update Date | 2020-11-10 |