| NPI | 1154108983 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11028162) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11028162) | 
| Enumeration Date | 2023-09-14 | 
| Last Update Date | 2024-02-26 |