| NPI | 1053098657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NM 73518) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 73518) |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2024-09-25 |