| NPI | 1528693033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 212054) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: LA 212054) |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2020-03-04 |