NPI | 1083165724 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704315890) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 2023057339) |
363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704315890) | |
Enumeration Date | 2016-10-18 |
Last Update Date | 2024-02-20 |