| NPI | 1376011965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP001675) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WA AP60909994) |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2020-09-09 |