| NPI | 1659555910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704245390) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704245390) |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2017-03-22 |