| NPI | 1578125019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5012020) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024178016) |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2020-07-09 |