| NPI | 1053685362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 31303) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9208812) |
| 363L00000X Nurse Practitioner (Licence: FL ARNP9208812) | |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2022-10-20 |