NPI | 1770127029 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704401240) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041472081) |
Enumeration Date | 2019-10-30 |
Last Update Date | 2024-02-15 |