| NPI | 1700524618 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2022017958) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209025216) | 
| Enumeration Date | 2022-05-23 | 
| Last Update Date | 2025-08-19 |