| NPI | 1336707959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3014638) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 27568) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: AZ 225445) | |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2020-11-01 |