| NPI | 1518612241 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024183320) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024183320) | 
| Enumeration Date | 2022-02-22 | 
| Last Update Date | 2025-02-10 |