NPI | 1871256396 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704394707) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 348430) |
Enumeration Date | 2021-10-21 |
Last Update Date | 2023-07-20 |