| NPI | 1912687534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: ND R45632) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: ND R45632) |
| Enumeration Date | 2023-07-19 |
| Last Update Date | 2023-09-14 |