| NPI | 1295138246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AZ AP11482) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS A810623) |
| 363L00000X Nurse Practitioner (Licence: AR A004893) | |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2021-05-05 |