NPI | 1255680500 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704269320) |
Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: CO 190380) |
Enumeration Date | 2012-08-31 |
Last Update Date | 2023-11-30 |