| NPI | 1619562816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5014331) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 219715) |
| Enumeration Date | 2021-03-09 |
| Last Update Date | 2025-10-08 |