NPI | 1528657756 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704325644) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704325644) |
363LF0000X Nurse Practitioner, Family (Licence: MI F12200407) | |
Enumeration Date | 2021-01-12 |
Last Update Date | 2022-01-05 |