| NPI | 1124684717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: PA SP020470) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN664671) |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2023-04-11 |