NPI | 1720383763 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 80) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN622174) |
363L00000X Nurse Practitioner (Licence: MN R176035-2) | |
Enumeration Date | 2011-01-24 |
Last Update Date | 2021-05-27 |