NPI | 1033494349 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN210856) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704285879) |
Enumeration Date | 2011-10-18 |
Last Update Date | 2015-03-02 |