| NPI | 1083390967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MS 906094) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 912643) |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2023-10-05 |