| NPI | 1720701303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: TN 32329) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner Critical Care Medicine (Licence: TN 32329) |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2022-11-30 |