| NPI | 1366867293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OR 201506048NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN169713) |
| Enumeration Date | 2014-03-01 |
| Last Update Date | 2019-10-28 |