| NPI | 1720597446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704223964) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704223964) |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2022-03-09 |