NPI | 1992148738 |
---|---|
Former Name | COURTNEY L NIBBE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 65606) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA MD-43539) |
Enumeration Date | 2013-04-11 |
Last Update Date | 2019-07-18 |