NPI | 1235649963 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704289843) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704289843) |
Enumeration Date | 2017-10-09 |
Last Update Date | 2017-10-09 |