| NPI | 1144705666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SD AG07180119) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC AG07180119) |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2018-10-01 |