| NPI | 1457003139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: WY 49265) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WY 49265) |
| Enumeration Date | 2022-01-24 |
| Last Update Date | 2022-03-28 |