| NPI | 1609177674 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: ND R34298) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 9842) | 
| Enumeration Date | 2010-11-08 | 
| Last Update Date | 2025-08-05 |