NPI | 1396043626 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704238769) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI F0211152) |
Enumeration Date | 2011-03-10 |
Last Update Date | 2016-01-15 |