NPI | 1699035360 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2012013879) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R180584-8) |
Enumeration Date | 2012-05-29 |
Last Update Date | 2012-09-24 |