| NPI | 1376172692 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AL 1-171693)  | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA GAA-NP000597)  | 
| Enumeration Date | 2020-04-07 | 
| Last Update Date | 2024-02-01 |