| NPI | 1376214262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209024276) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH AG06210021) |
| Enumeration Date | 2021-09-22 |
| Last Update Date | 2022-05-19 |