| NPI | 1972338382 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA NP95032777) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95022405) |
| Enumeration Date | 2024-09-05 |
| Last Update Date | 2024-12-04 |