| NPI | 1720790017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11022296) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11022296) |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2024-09-20 |