NPI | 1104864222 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704220636) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704220636) |
Enumeration Date | 2006-06-02 |
Last Update Date | 2018-08-03 |