NPI | 1265094544 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704329882) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704329882) |
Enumeration Date | 2019-07-08 |
Last Update Date | 2024-04-05 |