| NPI | 1366161341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: VA 0024185124) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: VA 0024185124) |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2023-08-01 |