| NPI | 1619354586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 2014015355) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NC 248751) |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2015-04-29 |