| NPI | 1164831509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71005163A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28161601A) |
| 363L00000X Nurse Practitioner (Licence: IN 71005163A) | |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2014-10-06 |