| NPI | 1508473893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 216212) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1015381) |
| 363L00000X Nurse Practitioner (Licence: TX 1015381) | |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2025-09-10 |