NPI | 1578226668 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-168329) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704257953) |
Enumeration Date | 2021-10-16 |
Last Update Date | 2024-11-18 |