| NPI | 1629415880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN204356) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA AG0513003) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2021-06-07 |