| NPI | 1407323132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO F07181228) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2018026391) |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2021-03-15 |