| NPI | 1649819350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95013809) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO APN0994985) |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2020-11-18 |