NPI | 1043672587 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704260469) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MI 4704260469) |
Enumeration Date | 2016-03-23 |
Last Update Date | 2024-12-25 |