NPI | 1417206285 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MI 4704270697) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH COA13805NP) |
Enumeration Date | 2012-09-07 |
Last Update Date | 2021-11-15 |