| NPI | 1790473692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: ID 73974) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 73974) |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2024-04-12 |