| NPI | 1811246135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: FL 11012481) |
| Additional Taxonomies | 104100000X Social Worker |
| 363LG0600X Nurse Practitioner Gerontology (Licence: FL 11012481) | |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2021-09-23 |