| NPI | 1831729086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY JOAN VAZQUEZ Medical Services Administrator 231-733-3525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2024-11-13 |