NPI | 1316560865 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MI 4704314623) |
Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: OR 202008147NP) |
Enumeration Date | 2020-05-19 |
Last Update Date | 2024-01-24 |