| NPI | 1619677697 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AL 1-155438) | 
| Additional Taxonomies | 251G00000X Hospice Care, Community Based (Licence: AL 1-155438) | 
| Enumeration Date | 2023-03-07 | 
| Last Update Date | 2023-10-11 |