| NPI | 1205536810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD AC005148) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5024078) |
| Enumeration Date | 2023-03-03 |
| Last Update Date | 2026-08-10 |