| NPI | 1649783754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD AC003700) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 12634) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MD AC003700) | |
| Enumeration Date | 2017-11-10 |
| Last Update Date | 2025-08-11 |