| NPI | 1063946358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024174765) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024174765) |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2022-01-27 |