NPI | 1104904325 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704133240) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704133240) |
Enumeration Date | 2006-11-02 |
Last Update Date | 2008-09-10 |