| NPI | 1366952376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5009940) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 4PG0MM) |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2024-02-16 |