| NPI | 1366018558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 11021) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 11021) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-05-28 |
| Last Update Date | 2026-02-18 |