NPI | 1649715194 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704363040) |
Additional Taxonomies | 247200000X Technician, Other (Licence: MI W230493585298) |
163WP0200X Registered Nurse, Pediatrics (Licence: MI 4704363040) | |
Enumeration Date | 2016-12-19 |
Last Update Date | 2023-07-13 |