NPI | 1356975916 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MI 4704301101) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4704301101) |
Enumeration Date | 2020-02-23 |
Last Update Date | 2021-03-18 |