NPI | 1225784846 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11017472) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704218324) |
Enumeration Date | 2022-02-22 |
Last Update Date | 2023-10-04 |