| NPI | 1700510567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 15744) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: AZ AG07220044) |
| Enumeration Date | 2022-07-15 |
| Last Update Date | 2025-11-12 |