| NPI | 1003480328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL aprn11022691) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH 0028945) |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2024-06-26 |