| NPI | 1013559319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL ME11004413) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11004413) |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2019-12-03 |