| NPI | 1164931689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP017937) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA TGRN035281) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: PA RN565313) | |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2017-10-03 |