| NPI | 1588309074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704325645) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704325645) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704325645) | |
| Enumeration Date | 2022-04-29 |
| Last Update Date | 2022-04-29 |