| NPI | 1164017612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL 11039304) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11039304) |
| 163W00000X Registered Nurse (Licence: AL 1-155862) | |
| 163W00000X Registered Nurse (Licence: FL 9691572) | |
| 363L00000X Nurse Practitioner (Licence: AL 1-155862) | |
| Enumeration Date | 2021-03-06 |
| Last Update Date | 2026-06-17 |