| NPI | 1003488537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: MI 4704323196) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 21160071638) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2022-12-05 |