| NPI | 1073028130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704266692) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704266692) |
| 363L00000X Nurse Practitioner (Licence: MI 4704266692) | |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2020-11-09 |