NPI | 1679090179 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704262481) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704262481) |
Enumeration Date | 2017-08-24 |
Last Update Date | 2023-09-11 |