| NPI | 1265948210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IA H119055) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 119055) |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2018-02-02 |