NPI | 1952777153 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704325915) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ ap7978) |
Enumeration Date | 2015-08-11 |
Last Update Date | 2020-12-28 |