| NPI | 1588046239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024192471) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5009491) |
| 363L00000X Nurse Practitioner (Licence: NY F307231) | |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2025-02-03 |