| NPI | 1205473923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 26888) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 26888) |
| Enumeration Date | 2019-12-01 |
| Last Update Date | 2022-03-22 |