NPI | 1457610529 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704218298) |
Additional Taxonomies | 163WL0100X Registered Nurse, Lactation Consultant (Licence: MI 4704218298) |
Enumeration Date | 2012-05-10 |
Last Update Date | 2023-07-24 |