| NPI | 1508471541 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP022487) | 
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: PA RN693565) | 
| Enumeration Date | 2020-09-15 | 
| Last Update Date | 2020-09-19 |