| NPI | 1710636675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC AG03220015) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5016085) |
| Enumeration Date | 2022-03-19 |
| Last Update Date | 2025-07-15 |