| NPI | 1164966982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP017003) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN651073) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2020-03-31 |