| NPI | 1568096360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704296953) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704296953) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704296953) | |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2022-10-18 |