| NPI | 1841617909 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 76300)  | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2014009619)  | 
| Enumeration Date | 2014-03-26 | 
| Last Update Date | 2025-06-30 |