| NPI | 1942840368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MS 903801) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 886309) |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2020-09-09 |