| NPI | 1902356272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: MI 4704256647) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704256647) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2018-11-13 |