| NPI | 1730706474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: DC RN1061378) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704310255) |
| 363L00000X Nurse Practitioner (Licence: MI 4704310255) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: DC RN1061378) | |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2022-09-27 |