| NPI | 1417589052 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2020004945) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2020004945) | 
| Enumeration Date | 2020-02-11 | 
| Last Update Date | 2023-10-17 |