| NPI | 1316429905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704362539) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 7817) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 7817) | |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2024-12-31 |