| NPI | 1275913824 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: ID NP-1571A)  | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: ID NP-1571A)  | 
| Enumeration Date | 2015-06-08 | 
| Last Update Date | 2023-05-09 |