| NPI | 1649762956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 7768) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 136508) |
| 363L00000X Nurse Practitioner (Licence: CT 7768) | |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2019-05-31 |