NPI | 1124327440 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704330546) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024168835) |
363LF0000X Nurse Practitioner, Family (Licence: PA SP010658) | |
Enumeration Date | 2011-03-25 |
Last Update Date | 2023-10-10 |