| NPI | 1043760200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP019911) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: WA AP60690424) |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2019-08-22 |