| NPI | 1124850557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MI 4704352468) |
| Additional Taxonomies | 163WG0600X Registered Nurse Gerontology (Licence: MI 4704352468) |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2024-08-15 |