| NPI | 1174992739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN9477790) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9477790) |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2021-04-01 |