NPI | 1548796964 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704258315) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 470258315) |
Enumeration Date | 2017-05-04 |
Last Update Date | 2024-07-30 |