| NPI | 1902870918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704223755) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704223755) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2021-02-22 |