| NPI | 1154690477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71003884A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71003884A) |
| Enumeration Date | 2011-12-15 |
| Last Update Date | 2012-03-27 |