| NPI | 1205550548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704328823) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 2022007784) |
| Enumeration Date | 2022-09-29 |
| Last Update Date | 2023-10-30 |