| NPI | 1548796964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704258315) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704258315) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2025-10-15 |