| NPI | 1700693587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AL 1-129732) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-129732) |
| Enumeration Date | 2024-12-16 |
| Last Update Date | 2025-01-03 |