NPI | 1669005880 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 12635) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN281026) |
363LF0000X Nurse Practitioner, Family (Licence: GA RN281026) | |
Enumeration Date | 2020-02-17 |
Last Update Date | 2025-05-13 |