| NPI | 1669953162 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN936301) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM CNP59910) | 
| 363L00000X Nurse Practitioner (Licence: FL APRN9363001) | |
| 363L00000X Nurse Practitioner (Licence: NM 59910) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 14775) | |
| Enumeration Date | 2018-08-23 | 
| Last Update Date | 2025-10-03 |