| NPI | 1861140410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: KS 53-81044) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 87683) |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2022-04-01 |