| NPI | 1356998710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71009467A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704362899) |
| 363L00000X Nurse Practitioner (Licence: IN 28208903A) | |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2020-07-13 |