| NPI | 1376972695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71004698A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71004698A) |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2014-04-01 |