| NPI | 1023488137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5007955) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 251G00000X) |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2019-09-24 |