NPI | 1669974879 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704318383-NSA17654) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 31.008092) |
363LF0000X Nurse Practitioner, Family (Licence: MI 4704318383) | |
Enumeration Date | 2018-03-03 |
Last Update Date | 2023-11-03 |