| NPI | 1376142893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: LA 207014) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 207014) |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2020-11-11 |