NPI | 1477066116 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11007788) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704210227) |
Enumeration Date | 2017-11-15 |
Last Update Date | 2022-09-27 |