NPI | 1033415757 |
---|---|
Former Name | LAURA J JAIME |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704224207) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704224207) |
Enumeration Date | 2011-01-27 |
Last Update Date | 2014-11-03 |