NPI | 1063562585 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704241860) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704241860) |
Enumeration Date | 2007-01-10 |
Last Update Date | 2017-11-06 |