| NPI | 1871069096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: AL 1-125066) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-125066) |
| 363L00000X Nurse Practitioner (Licence: TX 1206590) | |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2025-07-12 |