NPI | 1730280678 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ RN116559) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 090719-0) |
363LW0102X Nurse Practitioner, Women's Health (Licence: AZ RN116559) | |
363LW0102X Nurse Practitioner, Women's Health (Licence: MN R 090719-0) | |
Enumeration Date | 2006-09-25 |
Last Update Date | 2012-12-11 |