| NPI | 1811550866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OR 201903457NP-PP) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: OR AG03190056) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2020-11-10 |