| NPI | 1902606213 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 16517-33) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 16517-33) | 
| Enumeration Date | 2025-03-17 | 
| Last Update Date | 2025-03-17 |