| NPI | 1609655521 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OR 10016529) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 10016529) | 
| Enumeration Date | 2023-09-28 | 
| Last Update Date | 2024-04-19 |