NPI | 1053146225 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704264456) |
Additional Taxonomies | 363LS0200X Nurse Practitioner, School (Licence: FL RN9287905) |
Enumeration Date | 2024-09-05 |
Last Update Date | 2024-12-29 |