| NPI | 1407495872 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP021619) |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: PA 650843) |
| Enumeration Date | 2020-01-02 |
| Last Update Date | 2022-08-09 |