| NPI | 1053586602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MO 135103) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2023033843) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2023-08-18 |