| NPI | 1811350234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MI 4704190085) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704190085) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: MI 4704190085) | |
| Enumeration Date | 2016-04-02 |
| Last Update Date | 2021-01-29 |