| NPI | 1174151922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 23188) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5018827) |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2026-01-07 |