| NPI | 1174358519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: FL APRN11035142) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: FL SA7546) |
| Enumeration Date | 2024-09-05 |
| Last Update Date | 2025-07-11 |