| NPI | 1700405396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: WI 10001-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 10001-33) |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2025-03-11 |