| NPI | 1124522875 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 22096) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5010356) | 
| Enumeration Date | 2018-03-19 | 
| Last Update Date | 2022-11-02 |