NPI | 1164815676 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704318096) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL ARNP9268237) |
Enumeration Date | 2015-03-08 |
Last Update Date | 2022-10-18 |