| NPI | 1487103743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 8833) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024174029) |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2020-06-02 |