| NPI | 1548836596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 28952) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 28952) |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2022-03-18 |