NPI | 1154303865 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704186755) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN 164653 NP) |
Enumeration Date | 2005-11-17 |
Last Update Date | 2024-09-11 |