| NPI | 1598353187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 002418404) |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: OK 200605) |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2022-05-16 |