| NPI | 1619567575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN248628) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN248628) |
| Enumeration Date | 2021-01-24 |
| Last Update Date | 2021-01-24 |