NPI | 1659624138 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704149241) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 15347) |
364S00000X Clinical Nurse Specialist (Licence: CA 2258) | |
Enumeration Date | 2012-10-20 |
Last Update Date | 2012-10-20 |