NPI | 1740692482 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2478) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ND R41375) |
Enumeration Date | 2014-05-29 |
Last Update Date | 2023-03-07 |