| NPI | 1073926622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704205281) |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: MI 4704205281) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2019-06-03 |