NPI | 1891495420 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704333466) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4043844) |
363LF0000X Nurse Practitioner, Family (Licence: SC 29264) | |
Enumeration Date | 2023-03-02 |
Last Update Date | 2025-09-17 |