| NPI | 1205692563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 14868) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 10973) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IA H176799) | |
| Enumeration Date | 2024-02-26 |
| Last Update Date | 2026-04-02 |