NPI | 1033652151 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704285286) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP135111) |
363LF0000X Nurse Practitioner, Family (Licence: TX AP135111) | |
Enumeration Date | 2016-11-21 |
Last Update Date | 2019-07-10 |