| NPI | 1447797675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 20638) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC AG1116016) |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2024-01-30 |