NPI | 1982123550 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5362) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 85362) |
Enumeration Date | 2017-09-14 |
Last Update Date | 2020-08-07 |