| NPI | 1992477814 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024185456)  | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 8235)  | 
| Enumeration Date | 2021-09-29 | 
| Last Update Date | 2023-03-08 |