NPI | 1154177269 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704310806) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH APRN.CNP.0037431) |
163W00000X Registered Nurse (Licence: MI 4704310806) | |
Enumeration Date | 2024-04-29 |
Last Update Date | 2024-11-06 |