| NPI | 1528666864 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11008830) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11008830) | 
| Enumeration Date | 2020-10-09 | 
| Last Update Date | 2020-10-09 |