NPI | 1619677101 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 025609) |
363LF0000X Nurse Practitioner, Family (Licence: MI 4704209716) | |
Enumeration Date | 2023-03-06 |
Last Update Date | 2023-03-06 |