| NPI | 1003408311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 32858) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9520669) |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2022-11-03 |