| NPI | 1851058580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP028479) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN529443L) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: PA 363LA2200X) | |
| Enumeration Date | 2021-11-17 |
| Last Update Date | 2023-11-22 |