NPI | 1821559600 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11022980) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704301547) |
363LF0000X Nurse Practitioner, Family (Licence: FL RN9613614) | |
Enumeration Date | 2019-03-26 |
Last Update Date | 2025-01-06 |