NPI | 1811306228 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3711) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN R-216093-5) |
363LP2300X Nurse Practitioner, Primary Care (Licence: MN A0314022) | |
Enumeration Date | 2014-08-11 |
Last Update Date | 2023-12-21 |