| NPI | 1174359392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 280020) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5020862) |
| Enumeration Date | 2024-09-12 |
| Last Update Date | 2025-10-17 |