| NPI | 1609207323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71004761A) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 28211504A) |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2022-03-04 |