| NPI | 1184219560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD R042168) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: SD CP002082) |
| Enumeration Date | 2021-03-07 |
| Last Update Date | 2024-01-25 |