NPI | 1942673447 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 4123) |
Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: MN CNP 4123) |
Enumeration Date | 2015-11-05 |
Last Update Date | 2019-10-15 |