| NPI | 1104403112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: RI APRN03387) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 29296) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: HI 4727) | |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2025-10-02 |