| NPI | 1407514672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL 11015919) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11015919) |
| Enumeration Date | 2021-12-03 |
| Last Update Date | 2023-10-12 |