| NPI | 1265022206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11040959) |
| Additional Taxonomies | 208VP0000X (Licence: FL 11040959) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: FL 11040959) | |
| 163W00000X Registered Nurse (Licence: FL 9453562) | |
| Enumeration Date | 2021-01-23 |
| Last Update Date | 2025-10-05 |