NPI | 1427829829 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704348683) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704348683) |
Enumeration Date | 2024-01-15 |
Last Update Date | 2024-06-06 |