| NPI | 1104330083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 7359) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 7359) |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2017-12-21 |