| NPI | 1104403112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: RI APRN03387) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 29296) |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2022-12-12 |