| NPI | 1871586479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704133731) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 1515380) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2011-08-10 |