| NPI | 1790270213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5013289) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704258540) |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2021-05-11 |