| NPI | 1023697000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP022939) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN635596) |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2021-04-23 |