| NPI | 1801579420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95025982) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95025982) |
| Enumeration Date | 2023-08-10 |
| Last Update Date | 2024-02-08 |