NPI | 1780945014 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN F0612054) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 152989-4) |
Enumeration Date | 2012-06-04 |
Last Update Date | 2020-11-09 |