| NPI | 1982382511 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209.028076) | 
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: IL 041.468251) | 
| Enumeration Date | 2023-07-05 | 
| Last Update Date | 2025-06-13 |