NPI | 1265420228 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704284179) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 80211-030) |
Enumeration Date | 2005-10-12 |
Last Update Date | 2011-12-13 |