| NPI | 1609657816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: WA AP61494666) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: OR 10017243) |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2023-10-12 |