| NPI | 1053890004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: IL 209018017) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: IL 209018017) |
| Enumeration Date | 2018-08-10 |
| Last Update Date | 2018-09-07 |