| NPI | 1366089757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5019728) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN228377) |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2024-04-22 |