| NPI | 1710665625 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11027350) | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11027350) | 
| Enumeration Date | 2023-07-10 | 
| Last Update Date | 2024-09-24 |