| NPI | 1073050928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP017123) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP017123) |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2020-02-13 |