| NPI | 1376415174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MS 907864) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MS 907864) |
| Enumeration Date | 2025-09-22 |
| Last Update Date | 2026-02-26 |