| NPI | 1629569876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT 131446) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MT 71131) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-08-22 |