| NPI | 1962288027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209028000) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.028000) |
| Enumeration Date | 2023-09-05 |
| Last Update Date | 2023-11-21 |