NPI | 1538641105 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704320911) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28161934A) |
Enumeration Date | 2018-08-30 |
Last Update Date | 2022-03-25 |