| NPI | 1639573025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MS 901830) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 18744) |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2025-06-02 |