| NPI | 1508381609 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 007155) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 7155) | 
| Enumeration Date | 2017-08-09 | 
| Last Update Date | 2022-09-26 |