| NPI | 1073202495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KS Pending) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 1) |
| Enumeration Date | 2023-05-02 |
| Last Update Date | 2023-05-02 |