| NPI | 1205468030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0600X Registered Nurse, Gerontology (Licence: MD R196829) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R196829) |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2023-08-31 |