| NPI | 1528507886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 5000) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP 5000) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2023-12-14 |