| NPI | 1104693506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MI AG08230100) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MI AG08230100) |
| Enumeration Date | 2023-12-06 |
| Last Update Date | 2023-12-06 |