| NPI | 1245780659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112895) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2016035062) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 77424) | |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2019-08-16 |