| NPI | 1053103663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: MI 4704286539) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MI 4704286539) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: MI 4704286539) | |
| Enumeration Date | 2025-05-20 |
| Last Update Date | 2025-06-09 |