NPI | 1013403302 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704270660) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704270660) |
Enumeration Date | 2018-07-10 |
Last Update Date | 2023-10-24 |