| NPI | 1831627041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2016001665) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MO AG1115069) |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2022-06-01 |