| NPI | 1932811551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MD R197155) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R197155) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: DE LP-0010626) | |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2023-03-10 |