| NPI | 1760084420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: MI 4704339849) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MI 4704339849) |
| Enumeration Date | 2020-11-09 |
| Last Update Date | 2020-11-09 |