| NPI | 1750752093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5007638) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024186143) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: WA N361434832) | |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2023-07-05 |