NPI | 1649670316 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP001420) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R1983472) |
Enumeration Date | 2014-08-29 |
Last Update Date | 2022-03-30 |