| NPI | 1215380654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP016423) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN323469L) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2016-08-31 |