| NPI | 1497418883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 262668) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704331065) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209024572) | |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2024-01-02 |