| NPI | 1821055484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209006392) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704200188) |
| 363L00000X Nurse Practitioner (Licence: IL 209006392) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2016-04-06 |