NPI | 1720456577 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 4182) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP 4182) |
Enumeration Date | 2015-09-10 |
Last Update Date | 2024-01-29 |