| NPI | 1467938464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.019422) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704285025) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704285025) | |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2019-06-15 |