| NPI | 1730885328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 13124) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 13124) |
| 363L00000X Nurse Practitioner (Licence: AL 1-114296) | |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2024-07-20 |