NPI | 1720333685 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2507) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 123943-0) |
Enumeration Date | 2012-07-17 |
Last Update Date | 2024-10-17 |