NPI | 1326799016 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704273942) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704273942) |
Enumeration Date | 2022-01-13 |
Last Update Date | 2024-04-12 |