| NPI | 1639550809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA 199493) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 25978) |
| Enumeration Date | 2015-06-14 |
| Last Update Date | 2022-04-21 |