| NPI | 1831130541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704343498) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 003177) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 003177) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2019-03-29 |