| NPI | 1023508041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: LA AP09854) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA AP09854) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2020-07-09 |