| NPI | 1730806506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704287149) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MI 4704287149) |
| Enumeration Date | 2022-10-24 |
| Last Update Date | 2024-03-25 |