| NPI | 1033835996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: WI 10457875) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MI 4704366688) |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2024-02-08 |