| NPI | 1770904831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704274562) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704274562) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704274562) | |
| Enumeration Date | 2013-12-16 |
| Last Update Date | 2018-12-05 |