| NPI | 1083135909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2021028732) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 28220633A) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2021-08-25 |