NPI | 1700591724 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704402365) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 227728) |
363LF0000X Nurse Practitioner, Family (Licence: TN 32770) | |
Enumeration Date | 2023-01-16 |
Last Update Date | 2023-09-15 |