| NPI | 1629734298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: PA SP024065) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 12567) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: CO APN0999269-NP) | |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2023-12-05 |