NPI | 1235425208 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704210196) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX F0611058) |
Enumeration Date | 2011-06-28 |
Last Update Date | 2017-04-07 |