NPI | 1760063226 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 8133) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 8133) |
363LA2200X Nurse Practitioner, Adult Health (Licence: MN 8133) | |
Enumeration Date | 2021-04-16 |
Last Update Date | 2023-12-28 |