NPI | 1790288058 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704172273) |
Additional Taxonomies | 163WL0100X Registered Nurse, Lactation Consultant (Licence: MI 4704172273) |
Enumeration Date | 2018-03-13 |
Last Update Date | 2019-12-19 |