| NPI | 1245663129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ00551700) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 2013009922) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2015-09-24 |