NPI | 1174048854 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014540) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704295851) |
Enumeration Date | 2017-08-03 |
Last Update Date | 2024-03-01 |