| NPI | 1306220553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 16274) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 154603-30) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2025-01-21 |