| NPI | 1013398957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: MO 2015016102) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: KS 53-76780-092) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2016-10-07 |