| NPI | 1124779095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704298015) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704298015) |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-04-06 |