| NPI | 1578397303 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11036567) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL RN9411956) | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: FL RN9411956) | |
| Enumeration Date | 2024-08-26 | 
| Last Update Date | 2024-12-10 |