| NPI | 1942896253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704276249) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704276249) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704276249) | |
| Enumeration Date | 2020-12-21 |
| Last Update Date | 2024-06-03 |