| NPI | 1467796300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP018052) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN291146L) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2019-09-20 |