NPI | 1952554057 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704190454) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704190454) |
Enumeration Date | 2008-11-03 |
Last Update Date | 2019-10-23 |