NPI | 1568472637 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704211485) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704211485) |
Enumeration Date | 2006-08-09 |
Last Update Date | 2023-01-12 |