NPI | 1245213511 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704122796) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 1028 033) |
Enumeration Date | 2005-11-21 |
Last Update Date | 2013-07-02 |