| NPI | 1922796077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OR 10007097) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP61415533) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: WA AP61415533) | |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2023-12-11 |