NPI | 1750518395 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: AZ AP10142) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4704242161) |
Enumeration Date | 2009-06-21 |
Last Update Date | 2022-09-24 |