| NPI | 1861887754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704235679) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704235679) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704235679) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4707235679) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2021-03-01 |