| NPI | 1013566884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71009529A) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 28216495A) |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2020-12-29 |