NPI | 1174752281 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704239741) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 18530) |
Enumeration Date | 2009-07-09 |
Last Update Date | 2024-09-30 |