| NPI | 1225437221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: UT 105926164405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA H078686) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2019-03-15 |