NPI | 1134401193 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704267687) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704267687) |
Enumeration Date | 2011-09-15 |
Last Update Date | 2015-07-28 |