NPI | 1649733965 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704278523) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: MI 4704278523) |
Enumeration Date | 2019-04-12 |
Last Update Date | 2021-03-25 |