| NPI | 1710579883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11022634) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL 11022634) |
| 163W00000X Registered Nurse (Licence: FL 9452683) | |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2024-01-26 |