| NPI | 1841259926 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 763)  | 
| Additional Taxonomies | 208D00000X General Practice (Licence: WI 763)  | 
| 208D00000X General Practice (Licence: WI 95815)  | |
| Enumeration Date | 2006-03-20 | 
| Last Update Date | 2024-02-22 |