| NPI | 1639669088 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 21835) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 21835) | 
| Enumeration Date | 2018-05-11 | 
| Last Update Date | 2023-11-07 |