| NPI | 1730612094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AL AG02170035) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL AG02170035) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2026-04-22 |