NPI | 1710532007 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP021277) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013516) |
363LF0000X Nurse Practitioner, Family (Licence: MI 4704356028) | |
Enumeration Date | 2019-08-05 |
Last Update Date | 2020-02-01 |