| NPI | 1053778332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 352360) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704243006) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: OH 352360) | |
| Enumeration Date | 2016-01-18 |
| Last Update Date | 2023-11-03 |