| NPI | 1700542040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 34002) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95124963) |
| 363L00000X Nurse Practitioner (Licence: TN 34002) | |
| 363L00000X Nurse Practitioner (Licence: CA 95018722) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95018722) | |
| Enumeration Date | 2021-11-11 |
| Last Update Date | 2024-01-18 |