| NPI | 1487041521 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 24873) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95002324) | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 24873) | |
| Enumeration Date | 2015-04-15 | 
| Last Update Date | 2022-01-07 |