NPI | 1255059812 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704315230) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704315230) |
363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704315230) | |
Enumeration Date | 2022-08-19 |
Last Update Date | 2024-07-18 |