| NPI | 1104278316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71006417A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28175491A) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2026-01-13 |