| NPI | 1710529151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: PA SP022522) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: NJ 26NJ00970200) |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2024-09-06 |