| NPI | 1205823630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 2426-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 2426033) |
| 363L00000X Nurse Practitioner (Licence: MI 4704241650) | |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2021-04-06 |