| NPI | 1003365842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209014109) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209014109) |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2020-10-07 |