| NPI | 1205394764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MT NUR-APRN-LIC-143284) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-143284) |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2021-06-16 |