NPI | 1962984823 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704247696) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NV 814390) |
363LP2300X Nurse Practitioner, Primary Care (Licence: NV 814390) | |
Enumeration Date | 2018-09-06 |
Last Update Date | 2022-12-03 |