| NPI | 1104297118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: VA 0024173073) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001261296) |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2022-08-08 |