| NPI | 1063812360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024171987) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0024171987) |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2023-01-20 |