| NPI | 1760904841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 11089) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704326984) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP60928364) | |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2024-06-17 |