| NPI | 1700542040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 34002) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 34002) |
| 363L00000X Nurse Practitioner (Licence: TN 34002) | |
| Enumeration Date | 2021-11-11 |
| Last Update Date | 2025-05-19 |