| NPI | 1851154017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704299091) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MI 4704299091) |
| Enumeration Date | 2024-01-31 |
| Last Update Date | 2024-09-27 |