| NPI | 1942800768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND R50092) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704311240NSA200T8) |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2022-09-12 |