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 |