NPI | 1760657613 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 47041356860) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704135860) |
Enumeration Date | 2008-04-22 |
Last Update Date | 2023-05-10 |