| 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 |