| NPI | 1144735812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP018207) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP018207) |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2019-10-14 |