NPI | 1396340915 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI F10200602) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 347091) |
Enumeration Date | 2020-12-01 |
Last Update Date | 2024-02-12 |