NPI | 1013049352 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704110586) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704110586) |
Enumeration Date | 2007-03-12 |
Last Update Date | 2012-02-01 |