| NPI | 1942946108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: TN 30425) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: TN 30425) |
| Enumeration Date | 2022-05-10 |
| Last Update Date | 2023-05-18 |