| NPI | 1144707969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5014332) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5014332) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71008251A) | |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2021-05-05 |