| NPI | 1861052490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704418354) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP141613) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP141613) | |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2026-07-08 |