| NPI | 1972003564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN9292855) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9292855) |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2021-12-05 |