| NPI | 1215701982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: IN 71014605A) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: IN 71014605A) |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2024-02-13 |