| NPI | 1487051173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024172076) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704339208) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2022-02-23 |