| NPI | 1316393028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: MD R183080) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.18986-NP) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2022-03-17 |