NPI | 1518231232 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704237357) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704237357) |
363LF0000X Nurse Practitioner, Family (Licence: MI 1704237357) | |
Enumeration Date | 2012-02-27 |
Last Update Date | 2022-03-23 |