NPI | 1497157564 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704199639) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704199639) |
Enumeration Date | 2014-09-20 |
Last Update Date | 2015-04-07 |