| NPI | 1265127740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MD AC005559) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 28258644C) |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2024-06-28 |