| NPI | 1013791094 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2023029040)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2023029040)  | 
| Enumeration Date | 2023-08-22 | 
| Last Update Date | 2024-12-04 |