| NPI | 1104602614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH AG08230123) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: OH AG08230123) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH AG08230123) | |
| Enumeration Date | 2023-08-31 |
| Last Update Date | 2024-09-29 |