NPI | 1669535092 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 3063-033) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R142404-1) |
Enumeration Date | 2006-12-18 |
Last Update Date | 2018-02-26 |