| NPI | 1770981037 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704215131)  | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI L556999)  | 
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI L556999)  | |
| Enumeration Date | 2014-12-18 | 
| Last Update Date | 2022-07-21 |