| NPI | 1457942252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 10614) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 10614-33) |
| Enumeration Date | 2021-02-03 |
| Last Update Date | 2021-03-04 |