| NPI | 1811654502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 34878) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 228980) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 34878) | |
| Enumeration Date | 2021-11-17 |
| Last Update Date | 2023-11-13 |