| NPI | 1972025856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO AG06170163) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO AG06170163) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2022-10-14 |