| NPI | 1063052470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN256254) |
| Additional Taxonomies | 363LS0200X Nurse Practitioner, School (Licence: GA RN256254) |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2025-01-21 |