| NPI | 1063398642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: FL 11041909) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: FL 9443891) |
| Enumeration Date | 2025-08-11 |
| Last Update Date | 2025-08-27 |