| NPI | 1467023101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704314159) |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: MI 4704314159) |
| Enumeration Date | 2021-07-04 |
| Last Update Date | 2021-08-25 |