| NPI | 1659127793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2024009619) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 53-83024-081) |
| Enumeration Date | 2024-04-29 |
| Last Update Date | 2024-04-29 |